Black adolescent boys are at an increased risk for HIV, according to researchers, but a “culturally grounded” intervention geared toward educating mothers and sons about condom use and other protective measures promoted open communication between them about sex, which in turn could reduce the teens’ risk for STIs.

“Mother-son communication about sexual risks and behaviors can be an important protective factor for reducing STIs among African-American adolescent males,” Jingwen Zhang, PhD, an assistant professor in the department of communication at the University of California, Davis, told Infectious Diseases in Children. “Although research has long established the benefit of mother-son communication, mothers may avoid talking with their sons about sex owing to the fear of not knowing what to say or concerns that the conversation might go poorly.”

Zhang added that mothers who fear conversations about sex need help to build their skills and confidence in these conversations.

Black adolescent boys between the ages of 10 and 15 years and their mothers who lived in housing provided by the Philadelphia Housing Authority were randomly assigned to receive an HIV and STI risk-reduction intervention or a control intervention. The risk-reduction intervention was moderated by trained black women from the housing sites who obtained a high school diploma or a GED and educated six to nine mothers in a group. The moderators facilitated 16 1-hour modules that included ways to reduce sexual risk behaviors for oral, vaginal and anal sex. Strategies used for training included brainstorming, small group discussions, games, videos and music, experiential exercises such as role-play scenarios and behavioral homework assignments targeted to the community.

Once the 16 modules were completed, two 3-hour booster sessions were held after 3 months and after 6 months.

Of the 525 mother and son pairs included in the study, 69.7% finished the follow-up surveys. Those who were included in the HIV and STI risk-reduction intervention were more likely to talk with their sons about sexual health, including sexual intercourse, birth control, HIV/AIDS prevention and condom use compared with those who were in the control group. Additionally, mothers who participated in the intervention were more likely to give their sons a condom before he left the home.

Although the intervention was successful at promoting communication about sexual risk behaviors, its efficacy decreased over time. For example, mothers more likely to give their sons condoms 3 months after the intervention compared with 24 months after the intervention, and discussions about sexual intercourse, condom use and HIV had reduced effects at the 24-month follow-up.

Zhang and colleagues noted that younger mothers discussed the topic more frequently than older mothers. Participants were more likely to communicate when they had higher levels of education. The marital status of the mother did not affect communication between mothers and sons.

Zhang said physicians can help to establish a healthy family norm for openly discussing sex, risks and protective factors.

“Primary care providers can talk to parents, especially mothers, about the importance of parent-child communication regarding sexual risks. Providers can consider compiling a list of useful resources for parents to learn about potential sexual risks for their adolescents and how to talk about protective behaviors using role-play scenarios,” Zhang said. “A one-time conversation may not generate a lasting effect. Thus, it is important to remind parents to talk with their adolescents about protecting themselves often and actually giving them condoms to use.”

Additionally, she said that repeated conversations on the topic can help teenagers remember that they are expected to use protections and encourage them to ask their parents questions when they encounter difficult situations. – by Katherine Bortz

Disclosures: The authors report no relevant financial disclosures.

Jingwen Zhang

Black adolescent boys are at an increased risk for HIV, according to researchers, but a “culturally grounded” intervention geared toward educating mothers and sons about condom use and other protective measures promoted open communication between them about sex, which in turn could reduce the teens’ risk for STIs.

“Mother-son communication about sexual risks and behaviors can be an important protective factor for reducing STIs among African-American adolescent males,” Jingwen Zhang, PhD, an assistant professor in the department of communication at the University of California, Davis, told Infectious Diseases in Children. “Although research has long established the benefit of mother-son communication, mothers may avoid talking with their sons about sex owing to the fear of not knowing what to say or concerns that the conversation might go poorly.”

Zhang added that mothers who fear conversations about sex need help to build their skills and confidence in these conversations.

Black adolescent boys between the ages of 10 and 15 years and their mothers who lived in housing provided by the Philadelphia Housing Authority were randomly assigned to receive an HIV and STI risk-reduction intervention or a control intervention. The risk-reduction intervention was moderated by trained black women from the housing sites who obtained a high school diploma or a GED and educated six to nine mothers in a group. The moderators facilitated 16 1-hour modules that included ways to reduce sexual risk behaviors for oral, vaginal and anal sex. Strategies used for training included brainstorming, small group discussions, games, videos and music, experiential exercises such as role-play scenarios and behavioral homework assignments targeted to the community.

Once the 16 modules were completed, two 3-hour booster sessions were held after 3 months and after 6 months.

Of the 525 mother and son pairs included in the study, 69.7% finished the follow-up surveys. Those who were included in the HIV and STI risk-reduction intervention were more likely to talk with their sons about sexual health, including sexual intercourse, birth control, HIV/AIDS prevention and condom use compared with those who were in the control group. Additionally, mothers who participated in the intervention were more likely to give their sons a condom before he left the home.

Although the intervention was successful at promoting communication about sexual risk behaviors, its efficacy decreased over time. For example, mothers more likely to give their sons condoms 3 months after the intervention compared with 24 months after the intervention, and discussions about sexual intercourse, condom use and HIV had reduced effects at the 24-month follow-up.

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Zhang and colleagues noted that younger mothers discussed the topic more frequently than older mothers. Participants were more likely to communicate when they had higher levels of education. The marital status of the mother did not affect communication between mothers and sons.

Zhang said physicians can help to establish a healthy family norm for openly discussing sex, risks and protective factors.

“Primary care providers can talk to parents, especially mothers, about the importance of parent-child communication regarding sexual risks. Providers can consider compiling a list of useful resources for parents to learn about potential sexual risks for their adolescents and how to talk about protective behaviors using role-play scenarios,” Zhang said. “A one-time conversation may not generate a lasting effect. Thus, it is important to remind parents to talk with their adolescents about protecting themselves often and actually giving them condoms to use.”

Additionally, she said that repeated conversations on the topic can help teenagers remember that they are expected to use protections and encourage them to ask their parents questions when they encounter difficult situations. – by Katherine Bortz